Deans' stroke musings: Can stroke survivors with severe upper arm disability achieve clinically important change in arm function during inpatient rehabilitation? A multicentre, prospective, observational study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, July 7, 2014

Can stroke survivors with severe upper arm disability achieve clinically important change in arm function during inpatient rehabilitation? A multicentre, prospective, observational study

It is only USD 27.50/EUR 20.00 . Will your doctor spend that piddling amount of money to solve your chronic spasticity problem?
http://iospress.metapress.com/content/am72n140571l5pq2/

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Authors

Kathryn S. Hayward¹, Suzanne S. Kuys², Ruth N. Barker^{3, 4}, Sandra G. Brauer¹

¹Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
²School of Rehabilitation Sciences, Griffith University, Gold Coast, Australia 4217; and Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia
³Discipline of Physiotherapy, School of Public Health Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
⁴Community Rehab Northern Queensland, Townsville Mackay Medicare Local, Townsville, Australia

Abstract

BACKGROUND: Severe arm disability is considered to indicate poor potential to recover arm function. OBJECTIVE: Determine if stroke survivors with severe upper arm disability can achieve a clinically important change in arm function on discharge from inpatient rehabilitation. METHODS: 618 stroke survivors from 16 inpatient rehabilitation units were assessed on admission and discharge using the Motor Assessment Scale Item 6 Upper Arm Function (MAS6). Admission scores defined participants with severe (MAS6 ≤2) and mild/moderate (MAS6 >2) upper arm disability. A clinically important improvement was evaluated according to: 1) statistical significance; 2) minimal clinical importance difference (MCID); and 3) shift in disability status i.e., severe to mild/moderate. Achievers of a MCID and shift were compared to non-achievers. RESULTS: Stroke survivors with severe upper arm disability (n = 226) demonstrated a significant improvement in arm function (p < 0.001) at discharge. A MCID was achieved by 68% (n = 155) and a shift from severe to mild/moderate upper arm disability on discharge by 45% (n = 102) of participants. Achievers had a significantly shorter interval from stroke onset to inpatient rehabilitation admission (p < 0.002). CONCLUSION: Stroke survivors with severe upper arm disability can achieve clinically important improvements during inpatient rehabilitation.